New PREDICT publications

Congratulations to the following authors:

Babl FE, Tavender E, Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT).
From knowledge generation to synthesis to translation.
Emerg Med Australas. 2021 Apr;33(2):192-194

Project snapshot: APSOS-1

Australian and New Zealand Prospective Sepsis Observational Study-1 

Multi-centre, prospective observational study to investigate the prevalence, management, and outcomes of children with sepsis.

Setting and target: 

>10 PREDICT sites in Australia and New Zealand.

Inclusion criteria:

Age <18 years, requiring hospital admission for admission for IV/IM/IO antibiotics, circulatory support (IV fluid bolus or inotrope).Children aged 6 months – 18 years, requiring hospital admission for sepsis and >1 fluid bolus.

Exclusion criteria:

Patients receiving inotrope / vasopressor for indications other than sepsis, post-operative cardiac surgical patients, post-operative solid organ transplant patients.

Ethics and consent:

Ethics approval for verbal consent for 90-day follow-up (text, email, or phone); enrol patient when meeting inclusion criteria. Consent by enrolling clinician or within 24 hours by research team.

Status:

APSOS 1 will begin recruitment in March 2021 (in conjunction with PROMPT Bolus), study duration 1 year.

Study duration:

1 year.

Project snapshot – Prompt Bolus

Pragmatic Paediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS)

A pragmatic, international randomised controlled trial comparing 0.9% saline to balanced fluids for sepsis resuscitation and initial maintenance.

This study aims to:

To evaluate the effectiveness and safety of balanced fluids for sepsis resuscitation and initial maintenance compared to 0.9% saline.

Setting and target: 

>10 PREDICT sites in Australia and New Zealand; 2200 patients; MRFF funded. 23 PECARN (US) sites; 4500 patients; NIH funded. 12 PERC (Can) sites; 2600 patients; CIHR funded.

Primary outcome:

Major Adverse Kidney Events (MAKE 30) at hospital discharge or within 30 days of enrolment (death, requirement for renal replacement therapy, persistent renal dysfunction).

Inclusion criteria:

Children aged 6 months – 18 years, requiring hospital admission for sepsis and >1 fluid bolus.

Exclusion criteria:

40ml/kg fluid, clinician judgement not safe (suspected brain herniation, known hyperkalaemia / hypercalcaemia / hepatic or renal failure, known metabolic or mitochondrial disease, known pregnancy, known fluid allergy.

Ethics and consent:

Ethics approval for delayed consent (waiver of consent to randomise). Consent by the research team once patient stabilised.

Status:

PROMPT Bolus will begin recruitment at RCH in March 2021, study duration 4.5 years. Enrolment in the US started in August 2020. Enrolment in Canada has not yet started.

Australian and New Zealand sites:
  • Kidz First Hospital, Middlemore (NZ)
  • Waikato Hospital (NZ)
  • Starship Hospital (NZ)
  • Royal Darwin Hospital (NT)
  • Gold Coast University Hospital (QLD)
  • Queensland Children’s Hospital (QLD)
  • Westmead Children’s Hospital (NSW)
  • Sydney Children’s Hospital (NSW)
  • Perth Children’s Hospital, Perth (WA)
  • Monash Health
  • Women’s and Children’s Hospital, Adelaide (SA)
  • The Royal Children’s Hospital (VIC)
  • Townsville Hospital (QLD)

Project snapshot – SONIC

Study of Neck Injury Imaging in Children (SONIC): Improving the Diagnosis of Spinal Cord, Bone and Ligament Injuries

Many children sustain head and neck trauma during their lifetime. Significant neck injuries – to spinal cord, neck bones and connecting ligaments – can be identified by performing neck imaging with x-rays, or, if needed, computed tomography or magnetic resonance imaging. Yet, it is unclear which children should receive neck imaging in the emergency department (ED), especially in the context of increasing concerns about radiation-induced cancer in children and the discomfort and delays of immobilisation prior to imaging.

This study aims to:

(i) investigate the accuracy of existing neck injury clinical decision rules (CDRs) to detect neck injuries in children (external validation) of adult focussed CDRs and the newly developed paediatric PECARN CDR
(ii) derive and validate a new CDR for neck imaging in children (the SONIC CDR),
(iii) assess the cost implications of different CDRs in children.
(iv) investigate the epidemiology of cervical spine injuries in ANZ

Study design: 

Multicentre, prospective observational study.

Timeframe:

2020 – 2025

Sites:
  • Royal Children’s Hospital, Melbourne (VIC)
  • Monash Children’s Hospital, Melbourne (VIC)
  • Queensland Children’s Hospital (QLD)
  • Logan Hospital (QLD)
  • Sunshine Coast University Hospital (QLD)
  • Gold Coast University Hospital (QLD)
  • Perth Children’s Hospital, Perth (WA)
  • Children’s Hospital at Westmead (NSW)
  • Sydney Children’s Hospital (NSW)
  • Women’s and Children’s Hospital, Adelaide (SA)
  • Darwin Hospital (NT)
  • Kids First, Auckland (NZ)
  • Starship Children’s Hospital, Auckland (NZ)
Sample:

PREDICT ~30,000 (depending on prevalence of injuries), children aged <16 yrs with possible neck injury.

News:

We are currently finalising the ethics approval which includes waiver of consent for enrolment and data collection and verbal consent required only for telephone/text/email follow up. Development of the CRFs and Redcap data base is underway in view of a rolling study commencement to begin in May.

New PREDICT publications

The following manuscripts have been published.  Congratulations to the authors.

Franklin D, Shellshear D, Babl FE, Hendrickson R, Williams A, Gibbons K, McEnery K, Kennedy M, Pham TM, Acworth J, Levitt D, Oakley E, Schibler A; PARIS and PREDICT. High flow in children with respiratory failure: A randomised controlled pilot trial – A paediatric acute respiratory intervention study. J Paediatr Child Health. 2020 Dec 30. doi: 10.1111/jpc.15259. Epub ahead of print. PMID: 33377568. [link]

Babl FE, Tavender E, Ballard DW, Borland ML, Oakley E, Cotterell E, Halkidis L, Goergen S, Davis GA, Perry D, Anderson V, Barlow KM, Barnett P, Bennetts S, Bhamjee R, Cole J, Craven J, Haskell L, Lawton B, Lithgow A, Mullen G, O’Brien S, Paproth M, Wilson CL, Ring J, Wilson A, Leo GS, Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children. Emerg Med Australas. 2021 Feb 2. doi: 10.1111/1742-6723.13722. Epub ahead of print. PMID: 33528896. [link]

Tavender E, Ballard DW, Wilson A, Borland ML, Oakley E, Cotterell E, Wilson CL, Ring J, Dalziel SR, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Review article: Developing the Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children: An adoption/adaption approach. Emerg Med Australas. 2021 Feb 2. doi: 10.1111/1742-6723.13716. Epub ahead of print. PMID: 33528917. [link]

Lim JC, Borland ML, Middleton PM, Moore K, Shetty A, Babl FE, Lee RS, Acworth J, Wilson C, Than M, Craig S; ACEM EDEN and the PREDICT Network. Where are children seen in Australian emergency departments? Implications for research efforts. Emerg Med Australas. 2021 Jan 3. doi: 10.1111/1742-6723.13698. Epub ahead of print. PMID: 33393221. [link]

Florin TA, Tancredi DJ, Ambroggio L, Babl FE, Dalziel SR, Eckerle M, Mintegi S, Neuman M, Plint AC, Kuppermann N; Pediatric Emergency Research Networks (PERN) Pneumonia Investigators. Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)-study protocol. BMJ Open. 2020 Dec 2;10(12):e041093. doi: 10.1136/bmjopen-2020-041093. PMID: 33268423; PMCID: PMC7713188. [link]

Wilson CL, Hearps SJ, Tavender EJ, Phillips NT, Lawton B, Kinnear F, Beattie A, Mitenko H, Young R, Cole J, Kochar A, George S, Teo SS, Georgeson T, Michael A, Mukherjee A, King A, Gamage L, Archer P, Cassidy C, Rao A, Thosar D, Borland ML, Babl FE. Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand. Emerg Med Australas. 2020 Dec 22. doi: 10.1111/1742-6723.13694. Epub ahead of print. PMID: 33354919. [link]

Babl FE, Lyttle MD, Phillips N, Kochar A, Dalton S, Cheek JA, Furyk J, Neutze J, Bressan S, Williams A, Hearps SJC; MBiostat, Oakley E, Davis GA, Dalziel SR, Borland ML. Mild traumatic brain injury in children with ventricular shunts: a PREDICT study. J Neurosurg Pediatr. 2020 Nov 20:1-7. doi: 10.3171/2020.7.PEDS2090. [Epub ahead of print]. PMID: 33254139. [link]

Nagler J, Auerbach M, Monuteaux MC, Cheek JA, Babl FE, Oakley E, Nguyen L, Rao A, Dalton S, Lyttle MD, Mintegi S, Mistry RD, Dixon A, Rino P, Kohn-Loncarica G, Dalziel S, Craig S, the Paediatric Emergency Research Networks (PERN). Exposure and confidence across critical airway procedures in pediatric emergency medicine: An international survey study. J. Emerg. April 2021. 42:70-77. Doi: 10.1016/j.ajem.2020.12.075. [Epub ahead of print]. [link]

 

RHD and RA positions appointed

Following the nomination process, the following appointments on the PREDICT executive have been made:

Research Higher Degree scholar: Brooke Charters (2021 & 2022)
Research Assistant: Libby Haskell (2021) & Michael McCarron (2022)

Congratulations to the successful nominees. We look forward to your involvement on the PREDICT executive.

 

 

Head Injury Guideline released

The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children was officially launched on 3rd February 2021. The electronic version of the guidelines is now on the PREDICT website under the guidelines tab and a summary of the guideline recommendations and methods used will also be published in the journal Emergency Medicine Australasia.

The guidelines, are the product of a collaboration between emergency medicine physicians, GPs, neurosurgeons, radiologists, paramedics and nurses in Australia and New Zealand, and are the first nationally consistent protocols for treating children with head injuries.  

As some of you may know we had quite a bit of media here in Australia including multiple TV, radio and print.  Selected links below:

Don’t Forget the Bubbles

GP News – the official RACGP news

The Age

The JJ Report (US)

MCRI Bulletin

Congratulations to the large team who have been involved in this comprehensive piece of work.  With special thanks to Dr Emma Tavender, Knowledge Translation Co-ordinator for PREDICT, who was the driver of the process from conception to completion.

 

Head injury guideline launched

The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children was officially launched on 3rd February 2021 with a fanfare of print, radio and television coverage.  The electronic version of the guidelines is now on the PREDICT website under the guidelines tab and a summary of the guideline recommendations and methods used will also be published in the journal Emergency Medicine Australasia.

The guidelines, are the product of a collaboration between emergency medicine physicians, GPs, neurosurgeons, radiologists, paramedics and nurses in Australia and New Zealand, and are the first nationally consistent protocols for treating children with head injuries.  

Congratulations to the large team who have been involved in this comprehensive piece of work.

Getting to know you – Alison Partyka

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Alison Partyka from Royal North Shore Hospital.

“I am currently working as Acting Clinical Nurse Consultant in the Royal North Shore Emergency Department. The Royal North Shore Emergency Department is a mixed ED seeing over 25,000 paediatric presentations per annum.  I am interested in paediatric resuscitation specifically ventilation, simulation use in nursing education and paediatric family centered care.”

Welcome to PREDICT Alison!

Nominations for RA and RHD  positions on PREDICT Executive

We are now calling for nominations for the Research Assistant and the Research Higher Degree positions for the PREDICT Executive.  These positions are usually held for 1 – 2 years and are selected by the existing Executive.

The nominations period closes on Friday 12th December 2020.

To be eligible,  you need to be an existing PREDICT member.

If you wish to nominate yourself please email Catherine.wilson@mcri.edu.au with the following details:

  • Your title and name
  • Your craft group and current position held
  • Your primary organisation
  • The state you are based in
  • Attach a brief CV

Please write a brief description of why you wish to be part of the PREDICT Executive and what skills you can bring to the position.  If you are a Research Higher Degree candidate please tell us what RHD you are undertaking and describe your research area of interest and your long term goals.

Taking part in the PREDICT Executive involves:

  • Attending approximately 10 monthly meetings per year (approximately 4 face to face and 6 teleconferences if no pandemics!)
  • Previewing the executive agenda then actively participating in meetings to give an independent opinion/advice
  • Bringing issues of importance to the network, to the meeting agenda for discussion
  • Reviewing and commenting on new studies when they are presented to the Executive
  • Following up on actions deemed necessary at the meetings
  • Reviewing and commenting on issues via email/telephone in between meetings as required
  • Helping to develop and then reinforcing PREDICT research guidelines and policy with members locally
  • Maintaining confidentiality in relation to sensitive issues discussed
  • Chairing sessions at the PREDICT members meeting upon request

Please feel free to contact Cate Wilson if you have any questions or wish to discuss involvement in anyway.